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Current Medicinal Chemistry 2022Thalidomide is an old well-known drug firstly used as morning sickness relief in pregnant women and then withdrawn from the market due to its severe side effects on... (Review)
Review
INTRODUCTION
Thalidomide is an old well-known drug firstly used as morning sickness relief in pregnant women and then withdrawn from the market due to its severe side effects on fetal normal development. However, over the last few decades, the interest in this old drug has been renewed because of its efficacy in several important disorders as, for instance, multiple myeloma, breast cancer, and HIV-related diseases due to its antiangiogenic and immunomodulatory properties. Unfortunately, even in these cases, many after effects as deep vein thrombosis, peripheral neuropathy, constipation, somnolence, pyrexia, pain, and teratogenicity have been reported showing the requirement of careful and monitored use. For this reason, research efforts are geared toward the synthesis and optimization of new thalidomide analogues lacking in toxic effects, able to erase these limits and improve the pharmacological profile.
AIMS
This review aims to examine the state-of-the-art concerning the current studies on thalidomide and its analogues towards cancer diseases focusing the attention on the possible mechanisms of action involved and the lack of toxicity.
CONCLUSION
In the light of the collected data, thalidomide analogues and their ongoing optimization could lead, in the future, to the realization of a promising therapeutic alternative for fighting cancer.
Topics: Angiogenesis Inhibitors; Antineoplastic Agents; Female; Humans; Multiple Myeloma; Peripheral Nervous System Diseases; Pregnancy; Thalidomide
PubMed: 34165402
DOI: 10.2174/0929867328666210623143526 -
BMJ (Clinical Research Ed.) Nov 2018
Review
Topics: Female; Humans; Hyperemesis Gravidarum; Pregnancy; Prenatal Care; Quality of Life
PubMed: 30504245
DOI: 10.1136/bmj.k5000 -
La Revue Du Praticien Apr 2024NAUSEA AND VOMITING IN PREGNANCY. Nausea and vomiting during pregnancy are common symptoms experienced by pregnant women. In more severe cases, known as hyperemesis...
NAUSEA AND VOMITING IN PREGNANCY. Nausea and vomiting during pregnancy are common symptoms experienced by pregnant women. In more severe cases, known as hyperemesis gravidarum, these symptoms can become a pathological condition that can lead to significant complications in both the short and long term. Short-term complications include hydro-electrolyte imbalances, pregnancy termination, and growth retardation. Long-term complications may include anxiety disorders, depression, and post-traumatic stress disorder. Mild cases can often be alleviated through lifestyle and dietary adjustments or non-pharmacological treatments like ginger, acupuncture, or acupressure. However, moderate to severe cases require specific psychological support, anti-emetic treatments, and sometimes hospitalization with intravenous treatment and parenteral rehydration. Managing these cases is complex and challenging because it does not guarantee the complete disappearance of symptoms, which can pose difficulties for caregivers.
Topics: Humans; Female; Pregnancy; Vomiting; Hyperemesis Gravidarum; Pregnancy Complications; Nausea; Antiemetics
PubMed: 38814038
DOI: No ID Found -
The American Journal of Gastroenterology Oct 2022
Topics: Female; Humans; Hyperemesis Gravidarum; Nutritional Support; Pregnancy
PubMed: 36194027
DOI: 10.14309/ajg.0000000000001957 -
The Journal of Maternal-fetal &... Dec 2023Nausea and vomiting affect up to 80% of all pregnancies, sometimes so severely that the condition of hyperemesis gravidarum (HG) is established. HG may in addition be a... (Review)
Review
UNLABELLED
Nausea and vomiting affect up to 80% of all pregnancies, sometimes so severely that the condition of hyperemesis gravidarum (HG) is established. HG may in addition be a predisposing factor for Wernicke encephalopathy (WE), a severe and life-threatening condition due to vitamin B1 (thiamin) deficiency. If untreated, WE may progress to Korsakoff's syndrome, an irreversible cognitive disorder. We reported a case that recently occurred at our clinic and performed a systematic review of the literature to investigate the clinical presentation, maternal and perinatal outcomes and treatment of WE in women with HG.
METHODS
We performed a systematic review of case series and case reports searching the Medline database on Pubmed from inception until December 2021. We used as search terms (Wernicke encephalopathy) OR (Wernicke-Korsakoff syndrome) AND (hyperemesis gravidarum) AND (pregnancy) AND (thiamin deficiency). Articles were considered eligible for inclusion in our review if they described at least one case of WE due to thiamin deficiency in relation to HG. An overall of 82 cases of WE due to HG in pregnancy from 66 manuscripts, including our own, were selected.
RESULTS
The maternal mean age was 26.38 ± 5.23 years, while mean gestational week at hospitalization was 14.57 ± 4.12 after a mean of 6.6 ± 3.14 weeks of vomiting duration. WE manifestation occurred at a mean gestational age of 16.54 ± 3.06 weeks. Regarding clinical presentation, ocular signs and symptoms were reported by 77/82 (93.9%) women, 61/82 (74.4%) presented with ataxia and 63/82 (76.8%) with confusion. Dysarthria affected 15/82 women (18,3%), while muscular weakness was present in 36/82 (43.9%) and impaired reflexes in 42/82 (51.2%). Memory impairment involved 25/82 (30.5%) of the study population. Almost all cases reported a thiamin administration treatment, however data regarding the clinical course of the neurological condition and the perinatal outcomes were often missing and showed a great heterogeneity when reported.
CONCLUSION
WE is a challenging diagnosis, as its clinical presentation is nonspecific. A high clinical suspicion and the awareness of its possible predisposing conditions such as HG may help clinicians to get a prompt diagnosis and starting treatment, which are vital to prevent possible life-impairing neurological sequelae.
Topics: Pregnancy; Humans; Female; Young Adult; Adult; Infant; Male; Wernicke Encephalopathy; Hyperemesis Gravidarum; Korsakoff Syndrome; Brain; Thiamine
PubMed: 37322816
DOI: 10.1080/14767058.2023.2223678 -
The Journal of Maternal-fetal &... Jun 2022In this study, we aimed to determine the frequency of different intestinal microorganisms of patients with normal pregnancies and HG and to compare these frequencies...
PURPOSE
In this study, we aimed to determine the frequency of different intestinal microorganisms of patients with normal pregnancies and HG and to compare these frequencies between the two groups.
MATERIALS AND METHODS
This case-control study was carried out in Baskent University Department of Obstetrics and Gynecology and included 20 patients; 10 of whom had normal pregnancies and 10 of whom had HG. A stool flora scan was routinely planned for all patients. Transient and continuous fecal bacteria and fungal flora were analyzed. All data were evaluated statistically and their relationships with clinical condition were discussed.
RESULTS
The study group consisted of 20 pregnant women with a mean age of 31.5 years. All patients were nonsmokers and free of chronic diseases and of any medications. Aerobic and anaerobic bacteria groups, fungal colonies, and parasites were examined and bowel pH values were measured separately for each patient. Bacterial and fungal species outside the reference ranges were recorded for each patient. There was a statistically significant increase in spp. (:.01) and spp. (:.033) and a statistically significant decrease in spp.(:.008) in patients with HG compared to women with normal pregnancies. There was a significant difference between the group with HG and the group with normal pregnancies in terms of flora dysbiosis (:.001).
CONCLUSION
Our results suggest that gut dysbiosis may be a factor in HG. The effect of the severity of gut dysbiosis on the disease may be the subject of future studies.
Topics: Adult; Bacteria; Case-Control Studies; Dysbiosis; Feces; Female; Humans; Hyperemesis Gravidarum; Pregnancy; Pregnant Women
PubMed: 32519907
DOI: 10.1080/14767058.2020.1777268 -
Taiwanese Journal of Obstetrics &... Jul 2023
Topics: Pregnancy; Female; Humans; Hyperemesis Gravidarum; Hyperthyroidism
PubMed: 37407181
DOI: 10.1016/j.tjog.2023.04.002 -
Obstetrics and Gynecology Feb 2015
Topics: Doxylamine; Female; Humans; Morning Sickness; Ondansetron; Pregnancy; Pyridoxine
PubMed: 25611628
DOI: 10.1097/AOG.0000000000000651 -
Clinical Nursing Research May 2023Ondansetron is a widely administered medication for nausea and vomiting of pregnancy. Further examination of its teratogenic capacity is necessary. This study examines...
Ondansetron is a widely administered medication for nausea and vomiting of pregnancy. Further examination of its teratogenic capacity is necessary. This study examines the association between ondansetron treatment during pregnancy and birth defects and adverse obstetric outcomes. Patient data were extracted from Clalit Health Services, Israel. A propensity-score analysis was performed matching those exposed to ondansetron with those who were not. Findings identified 774 women exposed to ondansetron, matched 1:1 with unexposed control patients. No significant differences were found between the groups for: cleft palate, cardiovascular congenital abnormalities, spina bifida occulta, preterm delivery, or small for gestational age. Ondansetron may be a useful and safe alternative as treatment for women who suffer from hyperemesis gravidarum and do not respond to other antiemetic drugs. Notwithstanding, additional prospectively designed research is needed to establish the safety of ondansetron treatment during pregnancy.
Topics: Pregnancy; Infant, Newborn; Humans; Female; Ondansetron; Antiemetics; Hyperemesis Gravidarum; Nausea
PubMed: 36912091
DOI: 10.1177/10547738231159062 -
Gynecological Endocrinology : the... Aug 2020Gestational transient thyrotoxicosis (GTT) is associated with direct stimulation of the maternal thyroid gland by human chorionic gonadotropin (hCG). It is characterized... (Review)
Review
Gestational transient thyrotoxicosis (GTT) is associated with direct stimulation of the maternal thyroid gland by human chorionic gonadotropin (hCG). It is characterized by slightly higher thyroid hormone and lower thyroid-stimulating hormone (TSH) levels in early pregnancy and mild or no symptoms. While GTT must be distinguished from Graves' disease (GD), which is associated with maternal and fetal complications, treated GD and new-onset GD in pregnancy are occasionally challenging to distinguish. Evaluating serum hCG levels and TSH receptor antibody (TRAb) titers can help, but the results are not irrefutable due to pregnancy-related immunosuppression. Moreover, GTT can follow unusual clinical courses in relation to some pregnancy complications. Excessive hCG production can cause severe GTT symptoms in patients with hyperemesis gravidarum, trophoblastic disease, or multiple pregnancies. Thyrotoxicosis can emerge beyond the second trimester in patients with gestational diabetes mellitus and mirror syndrome, because of delayed elevations in the hCG levels. Detailed knowledge about GTT is necessary for correct diagnoses and its appropriate management. This review focuses on the diagnosis of GTT, and, particularly, its differentiation from GD, and unusual clinical conditions associated with GTT that require comprehensive management.
Topics: Diagnosis, Differential; Female; Humans; Hyperemesis Gravidarum; Pregnancy; Pregnancy Complications; Pregnancy Trimester, First; Thyroid Function Tests; Thyroid Gland; Thyrotoxicosis; Thyrotropin; Thyroxine; Triiodothyronine
PubMed: 32301638
DOI: 10.1080/09513590.2020.1754391